A Case of Term Delivery in Heterotopic Pregnancy following a Natural Conception / 대한산부인과학회지

Heterotopic pregnancy, simultaneous intrauterine and extrauterine gestations, is a relatively rare conditon with an estimated incidence of 1 in 30,000 pregnancies in a natural cycle. But the incidence of heterotopic pregnancies has been increased because of rising incidence of pelvic inflammatory disease, pelvic surgery, intrauterine device, the use of various ovulation induction and assisted reproductive technologies, such as in vitro fertilization and embryo transfer, gamate intrafallopian insemination. The early diagnosis of heterotopic pregnancy is very difficult. So there is a higher maternal morbidity, mortality and fetal loss. Thus careful pelvic examination, combined with serial beta hCG determinations and transvaginal sonography to evaluate the adnexal region are important. We experienced a case of 34-years-old multiparous women with heterotopic pregnancy in natual cycle confirmed by surgical removal of ruptured right tubal pregnancy and sonographic finding of the intrauterine pregnancy, which carried the intrauterine pregnancy to term delivery without complication at 39+5 weeks of gestation, and report this case with a brief review of the literature.

A Case of Primary Cutaneous Endometriosis at the Unbilicus / 대한산부인과학회지

Cutaneous endometriosis seems to be more common in women who have had a pelvic or abdominal operation and primary cutaneous endometriosis is very rare. In our hospital we experienced a 41-year-old woman who complained of the appearance at the umbilicus of a nodule and had not had operation. This nodule was responsible for recurrent pain and increasing in size and it was excised. Pathology findings revealed cutaneous endometriosis. So we present a case of primary cutaneous endometriosis with a brief review of literature.

A Case of Cephalopagus / 대한산부인과학회잡지

Conjoined twins are rare congenital malformation that occurs one in 50,000-100,000 births. The site and fusion are variable. In recent years, prenatal diagnosis of conjoined twins with ultrasonogram (US), computed tomography (CT), and magnetic resonance imaging (MRI) has been reported. Early prenatal diagnosis and assessment of the degree of conjoining provided couples with the option for pregnancy termination via vaginal delivery. We report a case of cephalopagus diagnosed prenatally by ultrasonogram in the second trimester and subsequently which was terminated, with a brief review of literature.

Prediction of Birth Weight by Fetal Thigh Volume with Use of Three-Dimentional Ultrasonography / 대한산부인과학회잡지

OBJECTIVE: To compare the accuracy of three-dimensional (3-D) ultrasound-assessed fetal thigh volumetry in predicting birth weight with that of other commonly used formulas composed of biparietal dimeter (BPD), abdominal circumference (AC), and femur length (FL) by two-dimentional (2-D) ultrasonography. METHODS: From May 1999 to February 2000 we performed a prospective study of ultrasonography on 100 pregnant women. We assessed the thigh volume of 100 fetuses using 3-D ultrasonography. Meanwhile their BPD, AC, and FL were measured by 2-D ultrasonography. All infants were delivered within 48 hours after the ultrasound examinations. RESULTS: The thigh volume assessed by 3-D ultrasonography was highly correlated with birth weight (r=0.414, n=100, p<0.0001). The 3-D formula had small mean values of absolute mean error (gm) (64.26), absolute mean error (%) (10.20+/-0.80). As well, the 2-D formulas had similar mean values. However, no significant differences in predicting birth weight were found between 3-D formula and 2-D formulas. CONCLUSION: The 3-D ultrasound method assessed by thigh volume showed better accuracy in predicting birth weight than 2-D methed. Further studies may be needed to confirm our conclusions.